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Atrieflimmer og -flutter

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Definisjon:
Atrieflimmer er uregelmessig atrieaktivitet med 350-600 impulser per minutt. Ved atrieflutter 250-350 impulser per minutt. Underliggende hjertesykdom hos mer enn 50%, ukjent årsak hos 20-30%. Vanligste årsaker er hypertensiv hjertesykdom og koronarsykdom. Inndeles i typene paroksysmal, persisterende eller permanent atrieflimmer.
Forekomst:
Prevalens i Norge ca. 0,5-1% av befolkningen. Økende forekomst med alder, prevalens 12% i aldersgruppen 75-84 år.
Symptomer:
Pasienter kan merke uregelmessig hjerterytme, hjertebank, tungpust, utmattelse, svimmelhet eller besvimelser. Ikke alle har symptomer.
Funn:
Ved u.s.: uregelmessig puls, ofte i området 100-200.
Diagnostikk:
Diagnosen bekreftes ved EKG. Hematologi, elektrolytter, stoffskifte-prøver og ekkokardiografi for å påvise ev. underliggende sykdom.
Behandling:
De aller fleste bør antikoaguleres for å redusere risiko for tromboemboliske komplikasjoner. Mange behøver frekvensregulerende medisiner og enkelte vil ha nytte av rytmeregulerende medisiner.
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  • Ingard Løge, spesialist allmennmedisin, redaktør NEL

Tidligere fagmedarbeidere

  • Bjørnar Grenne, PhD, spesialist i hjertesykdommer og indremedisin, overlege ved Klinikk for hjertemedisin, St. Olavs Hospital, Trondheim
  • Lars Hegrenæs, overlege, Hjertemedisinsk avdeling, St. Olavs Hospital, Trondheim
  • Eivind Meland, dr. med., spesialist allmennmedisin, førsteamanuensis, Institutt for allmennmedisin, Universitetet i Bergen